Perhaps new athlete-death stats will prompt new look at screening costs

More athletes are fatally collapsing on basketball courts, in swimming pools and on playing fields than once thought, new research has found, with 1 in 44,000 NCAA athletes dying of sudden cardiac death per year. The numbers are especially interesting in the context of screening costs.

Researchers have looked for effective ways to screen athletes before they start competing, but not everyone has agreed the benefits would outweigh the cost. Perhaps the new statistics might tip the equation toward more screening, at least for some athletes.

The severity of sudden cardiac death is obvious. The heart literally stops — 95 percent of victims die, and usually within minutes. The condition is caused by irregular electrical impulses that cause the heart to beat out of rhythm, then to suddenly stop beating (This is not the same as a heart attack, in which heart muscle dies because of lack of blood).

The heart can get out of sync in several ways. Coronary artery disease, in which blood vessels that carry oxygen to the heart are narrowed, is a major risk factor — usually in those slightly older than the typical high school or college athlete. But some risk is inherited. And severe physical exertion — such as sprinting in a gym — makes abnormal electrical activity more likely.

Athletes are commonly screened with a physical and a health history. An electrocardiogram (ECG) — which records the heart’s electrical activity — could better identify people at risk of sudden cardiac arrest. But the test is expensive. It can be difficult to get a straight "how much?" answer, but New Choice Health says the national average is $1,500.

A study last year from Stanford University School of Medicine suggested it would be cost-beneficial to give an ECG to all high school and college athletes in the U.S.

Adding an ECG screening would cost $42,900 per year of life saved, that study found. The calculated cost was similar to that for kidney patient dialysis ($20,000 to $80,000 per year of life saved) or for access to defibrillators in public places ($55,000-$162,000).

The Stanford study used a death rate of 1 in 50,000 athletes. So the new statistic, 1 in 44,000 athletes, would make ECG screening cost even less than $42,900 per year of life saved.

The new findings suggest that screening just some higher-risk athletes could lower the cost even further. The risk of sudden cardiac death for basketball players is a relatively high 1 in almost 11,400, for example, followed by swimming, lacrosse and football. African-American athletes have a death rate of 1 in almost 17,700 versus 1 in almost 58,700 for Caucasian athletes.

But to put sudden cardiac deaths in perspective: The chance that you die in a car wreck this year is about 1 in 6,000, according to this risk analysis. Even if you’re not an NCAA athlete.